title: Chronic hepatitis B: Enlarged perihepatic lymph nodes correlated with hepatic histopathology.
abstract: OBJECTIVE
  To assess the value of enlarged perihepatic lymph nodes in determining hepatic histopathology for chronic hepatitis B (CHB) by magnetic resonance imaging (MRI).
  
  
  METHODS
  Sixty-seven patients who were clinically and histologically diagnosed with CHB and 18 healthy subjects without history of liver disease underwent abdominal MRI. Histological diagnosis and hepatic inflammation (grade 0-4) and fibrosis (stage 0-4) were assessed by a simplified system for scoring in chronic viral hepatitis. The major imaging protocol included an axial breath-hold fat suppressed fast spoiled gradient echo T2-weighted imaging (T2WI), axial breath-trigger fat suppressed fast recovery fast spin echo T2WI, and axial and coronal fast imaging employing steady-state acquisition. Perihepatic lymph nodes larger than 5 mm in shortest diameter were noted.
  
  
  RESULTS
  The numbers and size indexes of lymph nodes greater than 5 mm in shortest diameter in hepatic hilum suggested inflammatory activity for subjects with grade 2 or higher, with a high accuracy of diagnosis (the area under the curves > 0.9, P < 0.001). The numbers of lymph nodes were 2 or more with a sensitivity of 87.27%, a specificity of 90.00%, an accuracy of 88.24%, a positive predictive value of 94.12%, and a negative predictive value of 79.41% in patients with grade 2 or higher, and the size indexes were no less than 180 mm(2) with a sensitivity of 83.64%, a specificity of 100%, an accuracy of 89.41%, a positive predictive value of 100%, and a negative predictive value of 76.92%. The numbers and size indexes of lymph nodes were not correlated with hepatic fibrosis. The signal intensity indexes of lymph nodes were no significant correlation with histological grading or staging of liver.
  
  
  CONCLUSIONS
  The numbers and size indexes of enlarged perihepatic lymph nodes for patients with CHB suggest inflammatory activity for subjects with grade 2 or higher.
authors.affiliation: Jian Shu, Fu-Gang Han, Guang-Cai Tang, Li Luo, Xin Chen, Department of Radiology, Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan Province, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Shu
authors.forename: Jian-Nong
authors.initials: JN
authors.lastname: Zhao
authors.forename: Fu-Gang
authors.initials: FG
authors.lastname: Han
authors.forename: Guang-Cai
authors.initials: GC
authors.lastname: Tang
authors.forename: Yin-Deng
authors.initials: YD
authors.lastname: Luo
authors.forename: Li
authors.initials: L
authors.lastname: Luo
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
keywords: Chronic hepatitis B; Histopathology; Inflammatory activity; Lymph nodes; Magnetic resonance imaging